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Abstract: Introduction and objectives
Equal opportunities to access technical advances with recognized clinical value should be a priority of the publicly-funded health system. We analyzed variability among all the Spanish autonomous communities in the use of cardiovascular techniques with an established indication and its relationship with economic indicators, burden of disease, and hospital mortality.
The activity registries of various Associations of the Spanish Society of Cardiology from 2011 to 2019 were analyzed for coronary angiography, overall percutaneous coronary intervention (PCI), primary PCI, implantable cardioverter-defibrillators (ICD), cardiac resynchronization therapy, and transcatheter aortic valve replacement (TAVR). Economic indices (gross domestic product and per capita health care expenditure) were obtained from public sources and data on attendance rates and mortality from the Resources and Quality in Cardiology (RECALCAR) reports of the Spanish Society of Cardiology. We analyzed the coefficient of variation for activity and the correlation of activity with regional economic indices, attendance rates, and risk-adjusted rates of in-hospital mortality.
We identified wide variability in the use of technologies, especially for primary PCI (18%), ICD (22%), cardiac resynchronization therapy (36%), and TAVR (42%). A certain correlation with attendance rates was seen only for overall PCI and ICD. In general, no significant correlation was found between the use of the techniques and the economic indices of wealth and expenditure. The correlation with in-hospital mortality showed no significant results, although this was the analysis with the greatest limitations because the impact of these techniques on survival is exerted more in the mid- and long-term.
The results of this study, despite its inherent limitations, show marked variability between autonomous communities in the use of cardiovascular technologies, which is not explained by economic differences or by hospital attendance rates due to the corresponding diseases.
Fuente: Revista Española de Cardiología Volume 75, Issue 10, October 2022, Pages 805-815
Año de publicación: 2022
Nº de páginas: 11
Tipo de publicación: Artículo de Revista
Url de la publicación: https://doi.org/10.1016/j.rec.2022.02.016
JOSE MARIA DE LA TORRE HERNANDEZ
LOZANO GONZÁLEZ, MANUEL
TAMARA GARCIA CAMARERO
SERRANO LOZANO, DAVID
JIMÉNEZ QUEVEDO, PILAR
GARCÍA DEL BLANCO, BRUNO
DÍAZ, JOSÉ F.
CRUZ GONZÁLEZ, IGNACIO
PÉREZ DE PRADO, ARMANDO
FERNÁNDEZ LOZANO, IGNACIO
CANO PÉREZ, OSCAR
DAVID CANTARERO PRIETO